Sepsis-induced lung injury is a common type of sepsis complicated with multiple organ dysfunction syndrome， whose uncontrolled inflammatory response and oxidative stress are the key pathological mechanisms. As an important pathway of anti-inflammatory and anti-oxidative stress， the nuclear factor-erythroid 2-related factor 2 （Nrf2） signaling pathway is very important in the occurrence and development of sepsis-induced lung injury. This review summarizes relevant research conducted over the past decade on the regulation of the Nrf2 signaling pathway by traditional Chinese medicine （TCM） to ameliorate sepsis- induced lung injury. It has been found that 14 kinds of TCM effective ingredients （including five types of compounds： flavonoids， terpenes， alkaloids， saponins， phenols） and 6 kinds of compound preparations （including three types of formulas： heat-clearing and detoxifying formulas， purgative formulas for promoting bowel movement， and formulas for reinforcing vital qi and consolidating the constitution） can inhibit inflammatory responses and oxidative stress by activating Nrf2 signaling pathway and intervening in related pathways such as those involving Kelch-like ECH-associated protein 1， heme oxygenase-1， antioxidant response element and AMP-activated protein kinase， thereby alleviating sepsis-induced lung injury.

Objective: To investigate the clinical efficacy and safety of pudendal nerve modulation (PNM) in the treatment of female pudendal neuralgia (PN)，so as to promote the clinical application of this technique. Methods: A retrospective analysis was conducted on 20 female PN patients who failed conservative treatment at Gongli Hospital during Nov.2020 and Oct.2023.All patients underwent simultaneous PNM and sacral nerve modulation (SNM) with the assistance of 3D printing navigation.Dual-stage test electrodes for PNM and SNM were implanted，followed by alternate therapeutic trial for each modality.Secondary conversion rates and longitudinal outcomes，including visual analogue score (VAS)，patient health questionnaire-9 (PHQ-9)，and quality of life (QoL) scores were compared preoperatively，post-stage Ⅰ，and at 3，6，and 12 months post-stage Ⅱ. Results: All operations were successful.After the trial phase，the secondary conversion rate for PNM was significantly higher than that for SNM; 16 patients (16/20，80%) chose the second-phase PNM implantation surgery，3 (3/20，15%) chose second-phase SNM implantation，and 1 (1/20，5%) had electrodes removed due to ineffective results from both trials.Further assessment revealed that the improvements in VAS，PHQ-9，and QoL scores for PNM patients were significantly better than those for SNM patients after the first phase of surgery and at 3，6 and 12 months after the second-phase conversion (P<0.05).No complications such as electrode migration or infection were observed during the follow-up of 12-15 months. Conclusion: PNM provides more effective relief of pain symptoms and improvements in depressive states for female PN patients compared to SNM.With the assistance of 3D printing navigation，the operation is simple and safe，and offers stable therapeutic effects.It is worthy of clinical promotion and application.

⁶⁰Co-γ ray irradiation has the unique advantages of high efficiency， strong penetration， operation at room temperature and no residue， which has been widely used in the sterilization of Chinese medicinal materials， decoction pieces， Chinese patent medicine. However， the irradiation effect may cause changes in the content of chemical components in Chinese materia medica or the emergence of new radiolysis products， leading to reduced efficacy and uncontrollable safety risks. This paper reviewed the relevant literature at home and abroad， summarized the effect of irradiation sterilization on various types of chemical compositions of Chinese medicinal materials and their preparations， and analyzed and explored the rule of change. The results showed that the content changes of various chemical components in Chinese materia medica after ⁶⁰Co-γ ray irradiation sterilization varied. The contents of most flavonoids， terpenoids， phenylpropanoids and quinones decreased after irradiation， and the degree of decrease increased with the elevated irradiation dose. The contents of lignans， alkaloids， isoflavones and some terpenoids did not change significantly before and after irradiation， while the content changes of triterpenoid saponins， dihydroflavonols， chalcones， sugars and glycosides after irradiation were not yet uniform. Therefore， it is recommended to pay attention to the compositional changes of irradiated Chinese medicines， strengthen the research on the standards of irradiated Chinese medicines， and standardize the irradiation and sterilization of Chinese medicines in order to promote the healthy and rational application of irradiated Chinese medicines.

Hypertriglyceridemia-associated acute pancreatitis is an inflammatory disorder of exocrine pancreas caused by metabolism disturbances of triglyceride-rich lipoproteins.Currently,hypertriglyceridemia-associated acute pancreatitis is characterized by an escalating incidence rate,a tendency for more severe cases,and a lack of therapeutic drugs.Traditional Chinese medicine has distinct advantages in treating this disease,but its theoretical framework has not yet been established.Hypertriglyceridemia-associated acute pancreatitis manifests itself as a febrile disease,aberrant accumulation of fat and turbidity may stem from dietary imbalances and visceral dysfunction in ordinary individuals.The prolonged accumulation of fat and turbidity can transform into turbid pathogen,subsequently engendering heat,constituting a pivotal pathogenic factor.Throughout the progression of the disease,the fiery pathogen consumes the fat and turbidity,resulting in the generation of toxic heat,which is a crucial mechanism in the exacerbation of the disease severity.Thus,this article posits therapeutic principles aimed at averting the transformation of fat and turbidity into turbid pathogen and counteracting toxic heat in this disease.This article reviews two key theories from traditional Chinese medicine classics relevant to hypertriglyceridemia-associated acute pancreatitis:the theory of fat-turbidity associated with hypertriglyceridemia and the febrile disease related to acute pancreatitis.Combining these traditional theories with modern research on the mechanisms that intensify hypertriglyceridemia-associated acute pancreatitis and the corresponding targets of traditional Chinese medicine,it suggests that the pathogenesis of"fat-turbidity-toxic heat"serves as the theoretical basis of traditional Chinese medicine for the aggravated severity of hypertriglyceridemia-associated acute pancreatitis.The article aims to offer new insights for the treatment of hypertriglyceridemia-associated acute pancreatitis.

Objective:To investigate the correlation between serum sclerostin and sarcopenia-related indicators in chronic kidney disease (CKD) patients, and to find biomarkers and potential therapeutic targets that can take into account both osteoporosis and sarcopenia.Methods:It was a single-centre cross-sectional study. The clinical data of CKD stage 5 patients undergoing maintenance hemodialysis regularly and CKD stage 1-5 non-dialysis inpatients in the Hemodialysis Centre of Guangzhou Red Cross Hospital from March 2021 to March 2023 were collected retrospectively. The enzyme-linked immunosorbent assay was used to detect the level of serum sclerostin. The anthropometric data such as height, weight, upper arm circumference, upper arm muscle circumference, skinfold thickness, pinch strength and handgrip strength were measured. Body composition analyzer was used to measure the body composition. The patients were divided into CKD stage 1-3 group, CKD stage 4-5 group, and stage 5 hemodialysis group. One-way ANOVA, Kruskal-Wallis H test, and chi-square test were used to compare the differences of demographics and clinical characteristics in different stages of CKD. Spearman correlation analysis and multiple linear stepwise regression analysis were utilized to analyze the correlation between serum sclerostin and sarcopenia-related indicators in CKD patients. Results:The study included 104 patients with CKD stage 5 hemodialysis and 104 patients with CKD stage 1-5 non-dialysis patients, with age of (61.8±13.7) years old and 114 males (54.8%). There were 89 patients (42.8%) with diabetic nephropathy and 67 patients (32.2%) with sarcopenia. As renal injury progressed, serum sclerostin levels were 0.4 (0.3, 0.9) ng/L, 0.5 (0.3, 1.1) ng/L, and 1.1 (0.6, 2.3) ng/L in patients with CKD stage 1-3, stage 4-5, and stage 5 undergoing hemodialysis ( χ2=8.934, P<0.001), and the prevalence of sarcopenia was 16.4% (10/61), 34.9% (15/43), and 40.4% (42/104) ( χ2=10.312, P=0.006), respectively. Spearman correlation analysis showed that serum sclerostin was negatively correlated with estimated glomerular filtration rate ( r=-0.314, P<0.001), pinch strength ( r=-0.229, P=0.007), skinfold thickness ( r=-0.254, P<0.001), appendicular skeletal muscle index ( r=-0.169, P=0.010), body cell mass ( r=-0.174, P=0.020), and phase angle ( r=-0.264, P<0.001), and positively correlated with serum phosphorus ( r=0.227, P=0.002) and intact parathyroid hormone ( r=0.297, P<0.001). Multiple linear stepwise regression analysis showed that lg[appendicular skeletal muscle index] was negatively correlated with male ( β=0.330, t=5.675, P<0.001) and serum sclerostin ( β=-0.125, t=-2.143, P=0.033), and positively correlated with body mass index ( β=0.474, t=8.090, P<0.001). Conclusion:Serum sclerostin can be used as a good index and a potential therapeutic target for sarcopenia in CKD patients.

BACKGROUND:The researchers noted that upon embedding clinical-grade catgut and polyglycolide-co-lactide threads in the normal human"Zusanli"(ST 36)acupoint,the local area displayed temporal and inflammatory stimulatory effects,resulting in thread differentiation.However,the underlying mechanism behind thread involvement remains to be studied. OBJECTIVE:To investigate the expression levels of calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin at point"Zusanli"(ST 36)in rats after embedding catgut and polyglycolide-co-lactide respectively at different time points. METHODS:110 male SD rats were divided into a blank group(10 rats),a catgut embedding group(50 rats),and a polyglycolide-co-lactide embedding group(50 rats)according to the random number table method.In the blank group,no thread was embedded.In catgut embedding group and the polyglycolide-co-lactide embedding group,the thread was embedded in the left side of the ST36 acupoint once.Tissue was collected from the left side of the ST36 acupoint area 8 hours,3,7,14,and 21 days after embedding.The expression levels of calcitonin gene-related peptide and 5-hydroxytryptamine were detected by immunohistochemistry,and the contents of leukotriene B4 and bradykinin were detected by ELISA. RESULTS AND CONCLUSION:(1)Compared with the blank group,the expression of calcitonin gene-related peptide,5-hydroxytryptamine,bradykinin,and leukotriene B4 was significantly increased in the 8 hours,3,7,14,and 21 days of the catgut embedding group(P<0.05);calcitonin gene-related peptide expression was significantly increased in 8 hours,3,7,and 14 days in the polyglycolide-co-lactide embedding group(P<0.05);the expression of bradykinin was significantly increased in 8 hours,3,and 7 days(P<0.05);the expression of leukotriene B4 was significantly increased at 8 hours,3,7,14,and 21 days(P<0.05).(2)Compared with the polyglycolide-co-lactide embedding group,the expression of calcitonin gene-related peptide was increased at 7,14,21 days after thread embedding(P<0.05),and the expression of 5-hydroxytryptamine was increased at 8 hours,3,7,14 and 21 days after thread embedding(P<0.05);contents of leukotriene B4 and bradykinin in tissues were increased at 8 hours,3,14 and 21 days after embedding(P<0.05)in the catgut embedding group.(3)The results show that calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin in the acupoint region alter after catgut embedding in the ST36 of rats,as well as the alteration of calcitonin gene-related peptide,leukotriene B4,and bradykinin is found in the acupoint region after polyglycolide-co-lactide embedding in rats,which may be one of the mechanisms involved in the local time sensitive stimulus effects caused by embedding threads at acupoints.Moreover,there is a discernible difference between the two thread types.

Lipid and glucose metabolism play crucial roles in maintaining energy homeostasis, and their dysregulation can lead to the development of metabolic disorders, such as obesity and diabetes. Studies indicate that the skeleton, involved in lipid and glucose metabolism, functions as an endocrine organ, regulating systemic metabolism through bone-derived molecules. Sclerostin is a protein mainly produced by osteocytes, possessing the ability to inhibit bone formation, and its antibodies have become therapeutic targets for treating osteoporosis. Recent evidence suggests that sclerostin also plays a role in lipid and glucose metabolism disorders. Therefore, through summarizing in vitro and in vivo researches, this article reviews the role of sclerostin in lipid and glucose metabolism, its relationship with obesity and diabetes, and potential role in the treatment of metabolic diseases in the future.

The domestic and international research progress on the regulation of gut microbiota by Traditional Chinese Medicine (TCM) ingredients and their impact on intestinal absorption and transportation were summarized, which provided assistance for subsequent clinical rational drug use targeting gut microbiota. Literature on the relationship between gut microbiota and intestinal absorption and transportation in recent years were reviewed and analyzed, and the mechanism of TCM ingredients regulating gut microbiota on drug absorption and transportation was elucidated. Research has found that TCM ingredients alter gut microbiota, thereby affecting intestinal barrier function and absorption of transport proteins, which is of great significance for rational clinical medication.

ObjectiveTo investigate the difference in bilateral lower limb muscle synergy mode during gait in patients after unilateral anterior cruciate ligament reconstruction. MethodsElectromyography from bilateral lower limb muscles during gait were collected from twelve male and eight female patients after unilateral anterior cruciate ligament reconstruction in Affiliated Hospital of Wuhan Sports University, from April to June, 2023. The data were analyzed using non-negative matrix decomposition algorithm to extract the number of muscle synergies in the affected and unaffected legs, the time to peak activation of muscle synergies and the relative weights of the muscles. ResultsSix types of muscle synergy were identified in the unaffected leg of males during gait, while five types were identified in the affected leg, lacking synergy 2 that mainly from the tibialis anterior muscle. Six types of muscle synergy were identified in both legs in females during gait. There was no significant difference in the time to peak activation of muscle synergies between both legs in males (P > 0.05). However, the time to peak activation of muscle synergies increased in females in the affected leg for synergy 3 and synergy 5 (P < 0.05). The relative weight of the rectus femoris was lower in synergy 1 in the affected leg in males (P < 0.05). For female, the relative weight of the vastus lateralis was higher and the relative weight of the biceps femoris was lower in synergy 2 in the affected leg in females (P < 0.05); while the relative weight of the rectus femoris was lower in synergy 3 (P < 0.05), and the relative weight of the biceps femoris was lower in synergy 6 (P < 0.05). ConclusionMales would freeze the muscle synergy dominating ankle dorsiflexion in affected leg to enhance ankle stability, and reduce the relative weight of rectus femoris during the loading response phase to weaken the knee landing cushioning. However, females would delay the activation of synergies dominating in loading response phase and the mid-stance phase, enhance the relative weight of vastus lateralis during the loading response phase, and reduce the relative weights of rectus femoris in the loading response phase and the relative weight of biceps femoris in the mid-stance phase, to limit knee flexion.

Objective To investigate the factors influencing the positioning error of conical beam CT(CBCT)radiotherapy and the occurrence of acute radiation dermatitis in breast cancer fixed by cervical and thoracic integrated membrane in order to provide a basis for personalized out-target external boundary,selec-tion of fixed mode and guidance of radiodermatitis clinical practice work.Methods A total of 147 patients with breast cancer in this hospital from June 2022 to October 2023 were selected as the study subjects,inclu-ding 74 cases of breast conserving operation and 73 cases of modified radical(excision)operation.During the treatment period,CBCT scanning once a week obtained the image and conducted the grey match with the planned CT images to acquire the translational error of X(left and right),Y(head and foot)and Z(abdominal and dorsal)and the rotational posing error of X(pitch),Y(roll)and Z(yaw)axis,and at the same time,the acute radiodermatitis in nearly 3 months during radiotherapeutic period was recorded.Results Compared with the Z axis,the translation error of X axis and Y axis was greater,the rotation error was smaller,and the differ-ences were statistically significant(P＜0.05).The PTV external boundary of X,Y and Z axis calculated by the formula was 0.70,0.76,0.46 cm respectively.There was no statistically significant difference in the posi-tioning error of each direction of left and right breast between breast conservation operation and breast resec-tion operation(P＞0.05).The correlation between the age with X,Y and Z axis translation errors was-0.14,0.18 and 0.10 respectively,which of the age with X,Y and Z axis rotation errors was 0.12,＜0.01,0.02 respectively.The occurrence of grade 1 acute radiodermatitis in the patients with breast conserving oper-ation was 100.0％(74/74),which in the patients with excision operation was 13.7％(10/73),the occurrence of grade 2 was 82.2％,which of grade 3 was 4.1％(3/73),and the difference between them was statistically significant(P＜0.05).Conclusion In the every day positioning and target area external expansion,particular attention should be paid to the X and Y axis translational directions and the Z axis rotation direction.Using the integrated cervicothoracic thermoplastic membrane for fixing breast cancer is not affected by the operation mode,affected side position and age.